Provider Demographics
NPI:1831807106
Name:HEARTLAND HOSPICE LLC
Entity type:Organization
Organization Name:HEARTLAND HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESIKA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-723-4663
Mailing Address - Street 1:2398 5TH AVE.
Mailing Address - Street 2:STE. 101
Mailing Address - City:BELL FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717
Mailing Address - Country:US
Mailing Address - Phone:605-723-4663
Mailing Address - Fax:
Practice Address - Street 1:2398 5TH AVE.
Practice Address - Street 2:STE. 101
Practice Address - City:BELL FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717
Practice Address - Country:US
Practice Address - Phone:605-723-4663
Practice Address - Fax:605-723-4667
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND HOME HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based